“Angst: Raising Awareness Around Anxiety,” was created by the Seattle-based film company IndiFlix in 2017. You can learn more about the movie — which features Olympic gold medalist Michael Phelps — at https://www.indieflix.com/angst.html.

Health experts say anxiety is a normal part of every day life.

But while most people experience it occasionally as stressful situations ebb and flow, an estimated fifth of the U.S. population’s daily activities are affected by persistent anxiety, which can lead to numerous physical and mental health problems if left untreated, according to the Anxiety and Depression Association of America.

This is why, as the second part of its three-part workshop series about suicide prevention and mental health education, the Rainier Foothills Wellness Foundation, the Enumclaw School District, and the Enumclaw Schools Foundation is hosting a showing of “Angst,” on Wednesday, March 6, from 6 to 8 p.m. in the Enumclaw High commons.

After the movie is finished, there will be an follow-up panel discussion with four Enumclaw School District counselors — Tina Hickcox from Kibler Elementary, Rebecca Bowen from Southwood Elementary, Sandy Wright from Thunder Mountain Middle School, and Kami Johnson from EHS.

In a group interview with them and several other district counselors, they all agreed that one of their biggest concerns when it comes to their students are their stress and anxiety levels, which appear to be on the rise, even for elementary school students.

“There’s more of an awareness with what’s happening in the world. The information that’s out there, there’s more access, so kids are bringing up things that are well beyond their years more frequently than before,” said Bowen, who’s been a counselor for more than 25 years. She added that she’s had students ask her about terrorists and suicide, topics that rarely came up in conversation pre-9/11. “There’s this connection they don’t have, the prefrontal cortex development, to understand how that relates to them personally. It has created, in my experience, a lot more general anxiety, with a lower ‘a’, not a capitalized diagnosable [disorder], amongst more children.”

This is normal brain development — according to the University of Rochester Medical Center, the brain typically doesn’t finish developing until the mid-20s. Until then, children and teenagers think with their amygdala, where the brain process emotions, whereas adults use their prefrontal cortex, where rational thinking is done.

This could explain why, as Enumclaw Middle School Counselor Kristina Grundmanis put it, middle and high schoolers have a hard time separating presentation from reality, especially on social media.

“I project my ideal life in my Instagram. That doesn’t mean that’s my day-to-day life. And I’m an adult and I understand that difference,” she said. “When you’re younger, everything you see is reality. Everything that is presented to you is reality.”

But the problem isn’t that we experience stress or anxiety, they all said. Those emotions, in a healthy, safe situation, ought to encourage people to be prepared and excel — you would never study for a test if you weren’t anxious about the outcome, Johnson said.

Instead, the issue is that some students don’t have the opportunity or time to healthily deal with that normal anxiety, which can build on itself.

“In addition to busy schedules and being more engaged in technology is less access to things that research has shown to reduce anxiety,” Bowen said. “Being out in nature, having calm time, mindfulness of just being, conversations with caring adults that are not distracted… a lot of that is hard to find these days in kids.”

And in a society so focused on instant gratification — especially instantaneous emotional gratification through social media — some students just don’t understand de-stressing takes time and effort, Johnson said.

“You can’t take five deep breaths and instantly feel better,” she continued. “It’s all about those neural pathways.”

For example, students that are constantly pulled from class because they tell their counselors that they’re anxious are training their brains to avoid stress rather than coping with it, Johnson said. This is not always a healthy coping mechanism, especially since avoiding class makes graduating high school an uphill battle.

“It’s difficult, once we get to high school, to have those times to teach them and say, it’s alright” to be stressed, Johnson continued.

This is why it’s important to start teaching students at a young age techniques to cope with stress, they all agreed. Wright said it helps when students take time to name their feelings and have a calm discussion about where their stress is originating from.

When students are exhibiting extreme stress, Grundmanis said one successful technique she uses is called “grounding.”

“One of my favorite questions to ask students when I see them starting to elevate and escalate is, ‘What do you smell right now?’ because it brings that attention to… what is that sensory input right then. And then we go through the other senses,” she said.

Bringing attention away from the emotional center of the brain to another part is a technique Scilla (pronounced Sheila) Andreen, the director of “Angst,” said she learned early on in her professional life.

“I get so much anxiety before my public speaking, when I’m doing a big presentation, so I carry a little smooth rock that I’m constantly touching, or I snap, because people don’t seem to notice when I snap, and I snap quietly,” Andreen said. “It helps to move the energy from the amygdala to the frontal cortex — anxiety can’t exist there.”

Although Andreen said she has some general and social anxiety in her life, that wasn’t why she decided to make a documentary about mental health.

“A friend of mine asked if I could make a movie about mental health, and I said no, I don’t even know how to touch that topic,” she said. “And she died by suicide, so I was very motivated to make a movie about mental health, and thought, if our audience is schools and communities and corporations around the world, how do we make a movie that audience is going to want to watch, from ages 10 and up?”

The answer she came to was anxiety, because she believes many more serious mental health issues stem from too much uncontrolled anxiety.

“We can fall into these bigger, deeper, medical health issues, whether it’s depression or OCD,” Andreen said, clarifying that there are genetic components to anxiety disorders, as well as environmental factors. “Anxiety is the tip of it, and if you can maintain a healthy dose of anxiety, that’s awesome. The minute it becomes a disorder, you have to address it.”

Addressing and treating actual anxiety disorders isn’t a part of the Enumclaw School District counselors’ jobs, the counselors said, although they are aware several of their students have diagnosis, and suspect several others could be diagnosed. They can help in a pinch — like Grundmanis using her grounding techniques to help a student out of a panic attack — but they all said when it comes to real disorders, they help parents refer out to specialists. After a child is diagnosed, they continued, then they can work with the mental health professional to aid the child in school.

Luckily, they added, with more available information about anxiety disorders out there — like the movie “Angst, — more parents are willing to have a conversation about anxiety disorders and help seek treatment for their children.

The phrase “anxiety disorder” is an umbrella term for several disorders, according to the National Institute of Mental Health, which include generalized anxiety disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder (OCD), separation anxiety disorder, agoraphobia, and other specific phobias.

And while depression isn’t classified as an anxiety disorder, there is a strong connection between the two.

The ADAA says anxiety disorders as the most common mental illnesses in the U.S., affecting 18 percent of the country’s population.

Of the myriad disorders, social anxiety disorder is one of the most common, affecting nearly 7 percent of Americans. According to a 2007 survey, 36 percent of people who identified as having social anxiety disorder waited 10 years or more before seeking treatment.

Other disorders, like generalized anxiety disorder and panic disorder, each affect about 3 percent of Americans, with women being twice as likely to be affected than men.

According to the ADAA and the National Institute of Mental Health, roughly a quarter to a third of children between the ages of 13 and 18 have an anxiety disorder, although only roughly 8 percent suffer from “severe impairment.”

“Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse,” the ADAA’s website reads.

But research also shows that anxiety disorders are highly treatable — though only 37 percent of people with a disorder seek treatment — the ADAA continued, and the Enumclaw School District counselors agreed that families tend to be more open now about discussing mental health and mental health treatment, and there are more services for people wishing to seek treatment, even in town, including Nexus Youth and Families and Valley Cities.

However, while many families appear to be willing to discuss mental health and even seek treatment for their child during a crisis, the counselors notice when there’s no followthrough, and they agreed that even when a crisis is over, seeking continued treatment is important.

“It will take time,” Johnson said. “There is no instant fix out there.”